Smaller anterior cruciate ligament (ACL) size in females has been hypothesized to be a key contributor to a higher incidence of ACL tears in that population, as a lower cross-sectional area (CSA) directly corresponds to a larger stress on the ligament for a given load. Prior studies have used a mid-length CSA measurement to quantify ACL size. In this study, we used magnetic resonance imaging to quantify the CSA along the entire length of the intact ACL. We hypothesized that changes in the ACL CSA along its length would have different patterns in males and females. We also hypothesized that changes in ACL CSA along its length would be associated with body size or knee size with different associations in females and males. MR images of contralateral ACL-intact knees of 108 patients (62 females, 13–35 years) undergoing ACL surgery were used to measure the CSA along the ACL length, using a custom program. For both females and males, the largest CSA was located at 37%–39% of ACL length from the tibial insertion. Compared to females, males had a significantly larger CSA only within the distal 41% of the ACL (p < 0.001). ACL CSA was associated with patient height and weight in males (r > 0.3; p < 0.05), whereas it was associated with intercondylar notch width in females (r > 0.3; p < 0.05). These findings highlight the importance of standardizing the location of measurement of ACL CSA.

中文翻译：

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三维磁共振成像分析显示前十字韧带横截面积沿其长度变化的性别特异性模式


女性中较小的前十字韧带 (ACL) 尺寸被认为是导致该人群中 ACL 撕裂发生率较高的一个关键因素，因为较小的横截面积 (CSA) 直接对应于韧带上较大的应力。给定负载。先前的研究使用中长 CSA 测量来量化 ACL 大小。在这项研究中，我们使用磁共振成像来量化沿完整 ACL 整个长度的 CSA。我们假设 ACL CSA 沿其长度的变化在男性和女性中会有不同的模式。我们还假设 ACL CSA 沿其长度的变化与身体尺寸或膝盖尺寸相关，在女性和男性中存在不同的关联。使用自定义程序，使用 108 名接受 ACL 手术的患者（62 名女性，13-35 岁）对侧 ACL 完整膝盖的 MR 图像来测量沿 ACL 长度的 CSA。对于女性和男性来说，最大的 CSA 位于距胫骨止点 ACL 长度的 37%–39% 处。与女性相比，男性仅在 ACL 远端 41% 范围内具有显着更大的 CSA ( p < 0.001)。男性 ACL CSA 与患者身高和体重相关（ r > 0.3； p < 0.05），而女性则与髁间切迹宽度相关（ r > 0.3； p < 0.05）。这些发现强调了标准化 ACL CSA 测量位置的重要性。